Chapter 2302: Chapter 2302: Much More Reliable
He’s an extraordinarily cute guy, making people feel he doesn’t really resemble a top student.
This might be the reason why Student Duan had to bow his head for a long time, akin to showing only half of what he knows.
Sometimes, a unique appearance isn’t unattractive, but it’s a kind of "guilt" nonetheless.
"No worries, go ahead," Doctor Cheng Yuchen encouraged his junior from the same school.
What’s there to fear? The seniors are here.
Upon receiving this command, Student Duan Sanbao tapped his pen against his notebook and quietly said, "There are three points that need careful identification. One point is the heart-chest ratio. Normally, a person’s heart-chest ratio is one to two. This patient’s heart-chest ratio is incorrect, exceeding one to two."
The way a top student speaks is different, with a deep and steady tone, unlike the previous guy’s flamboyance. The content is solid and full of practical knowledge, not wild guesses based on some age group.
Hmm? This person from Guodu does seem to have a scholarly aura. Zhao Zhaowei and others thought.
What is the heart-chest ratio? Like the width of the pneumothorax line, it requires finding accurate anatomical landmarks in medical imaging before measuring. This single point can stump quite a few medical students. There are just too many books to read in medicine, making it tough to remember everything all at once.
Students who remember the key points are searching the film for issues that Student Duan pointed out.
"Start with the diaphragm, right?" Student Zhao Zhaowei whispered to Student Zhang Desheng.
"Check the books when you get home," Zhang Desheng glared back. For classmates who haven’t studied well, even a top student has no time to teach. This is all basic knowledge.
"I was just unsure, that’s why I asked, not because I can’t remember," Zhao Zhaowei grumbled.
"Don’t be so insecure, okay? We’re in someone else’s territory." Zhang Desheng blinked hard at him.
In front of competitors, one has to pretend to be strong and shouldn’t emphasize their lack of memory or ability.
To know the heart-chest ratio, you first need the cardiac transverse diameter and chest cavity diameter. Dividing these gives the heart-chest ratio value.
As Student Zhao suggested, on the frontal chest X-ray, try to locate the right diaphragm apex anatomical landmark and draw a transverse line across it. The straight-line distance is generally the maximum chest cavity diameter. For the cardiac transverse diameter, visually look for the largest shadow transverse diameter of the heart.
The normal heart-chest ratio is 0.5, meaning the cardiac transverse diameter is half of the chest cavity diameter. In pediatrics, note that for children under three, as the heart is positioned obliquely due to diaphragm pressure, the ratio is greater, approximately 0.6. Other times, if it isn’t at 0.5, it’s crucial to thoroughly consider excluding any unhealthy conditions in the patient. Typically, when the heart-chest ratio exceeds normal proportions, based on the formula, it’s likely due to a larger numerator, indicating an enlarged heart, potentially suggesting heart disease traits in the patient. If the numerator is smaller, meaning a smaller chest cavity, checking the proportion between organs and chest cavity on the image can determine if it’s due to a smaller chest cavity, a less likely scenario than an enlarged heart.
Does this patient have heart disease? Everyone looked at the film, and it was clear that the evidence Student Duan unearthed was far more credible than the previous guy’s suspicion of tuberculosis.
Among the crowd who listened to Student Duan’s words, the seniors seemed quite approving. Doctor Cheng Yuchen nodded, saying, "Keep going."
Student Duan stated there were three suspicious points, but he had only mentioned the first one.
Everyone waited together for Student Duan to continue.
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